RT Book, Section
A1 Sathiyakumar, Vasanth
A1 Jones, Steven R.
A1 Martin, Seth S.
A2 Kang, Sewon
A2 Amagai, Masayuki
A2 Bruckner, Anna L.
A2 Enk, Alexander H.
A2 Margolis, David J.
A2 McMichael, Amy J.
A2 Orringer, Jeffrey S.
SR Print(0)
ID 1161338650
T1 Xanthomas and Lipoprotein Disorders
T2 Fitzpatrick's Dermatology, 9e
YR 2019
FD 2019
PB McGraw-Hill Education
PP New York, NY
SN 9780071837798
LK dermatology.mhmedical.com/content.aspx?aid=1161338650
RD 2024/04/24
AB AT-A-GLANCEXanthomas  are  plaques  or  nodules  consisting  of  an  abnormal  excess  of  lipid  primarily  in  the  skin  or  tendons.Clinically,  xanthomas  may  be  divided  into  eruptive,  tuber-eruptive  or  tuberous,  tendinous,  or  planar  forms.  Two  traditionally  noninherited  variations  include  verruciform  and  disseminated  xanthomas,  both  of  which  have  a  propensity  for  largely  noncutaneous  manifestations.Xanthomas  are  not  disease  entities  themselves  but  are  signs  of  various  lipoprotein  disorders,  which  may  be  primary  lipid  disorders  or  secondary  disorders  from  a  variety  of  causes  including  hepatic,  hematologic,  and  endocrine  sources.The  key  pathogenesis  of  xanthoma  formation  consists  of  the  downstream  formation  of  foam  cells,  which  involves  an  interplay  of  various  lipoproteins  including  chylomicrons,  very-low-density  lipoproteins  (VLDLs),  chylomicron  and  VLDL  remnant  lipoproteins,  low-density  lipoproteins,  and  high-density  lipoproteins.Primary  dyslipidemias,  designated  as  Types  I  to  V,  have  been  historically  categorized  into  various  phenotypes  described  by  Fredrickson,  Levy,  and  Lees,  based  on  the  elevated  lipoprotein  fractions  found  in  serum.Diagnosis  of  xanthoma  is  based  on  clinical  and  morphologic  characteristics  of  the  lesions  and  identifying  the  underlying  lipid  disorder.Treatment  of  xanthoma  is  aimed  at  the  underlying  lipid  disorder,  and  typically  involves  lifestyle  changes  (diet,  weight  loss,  smoking  cessation)  and  medications  (statins,  adjuvant  agents,  PCSK9  inhibitors).Young  patients  with  xanthomas  and  those  with  suspected  familial  dyslipidemias  should  be  referred  for  genetic  testing  and  counseling.